The Clinical Significance Of Vascular Nerve Invasion In Gastric Cancer

Part 1 correlation analysis of VNI and clinicopathological factors in gastric cancer Objects:Gastric cancer refers to the malignant tumor occurring in the gastric epithelium,with high morbidity and mortality,which seriously threatens human health.At present,judging whether GC is accompanied by VNI can guide the selection of postoperative adjuvant treatment,and many studies have shown that VNI is related to a variety of clinicopathological factors,but no conclusion has been reached.Therefore,it is of great significance to study the influencing factors of VNI in GC patients.The purpose of this study was to investigate the correlation between various clinicopathological features and VNI in patients with GC.Methods:Clinical and pathological data of 247 GC patients who had operation in our hospital from January 2014 to December 2014 were retrospectively analyzed.In order to evaluate risk factors of VNI in GC patients,we included 12 clinical and pathological status.Including gender,age,maximum diameter of the tumor,degree of differentiation,depth of infiltration,lymph node metastasis,VI,NI,VNI,cancer nodule,mucinous adenocarcinoma,signet ring cell carcinoma.Results:PVI was observed in 64.4%of GC patients.Chi-square tests showed that the major factors for PVI in GC patients were the degree of differentiation,depth of infiltration,positive lymph node metastasis,maximum tumor diameter,positive tumor nodule,and mucinous adenocarcinoma.Logistic regression analysis showed that positive lymph node metastasis was significantly risk factor for PVI in GC patients.PNI was observed in 53.0%of GC patients.Chi-square tests showed that the major factors for PNI in GC patients were degree of differentiation,depth of infiltration,positive lymph node metastasis,maximum tumor diameter,positive tumor nodule.Logistic regression analysis showed that infiltration depth and positive lymph node metastasis were significantly risk factors for PNI in GC patients.PVNI was observed in 43.7%of GC patients.Chi-square tests showed that the major factors for PVNI in GC patients were degree of differentiation,depth of infiltration,positive lymph node metastasis,maximum tumor diameter,positive tumor nodule.Logistic regression analysis showed that infiltration depth and positive lymph node metastasis were significantly risk factors for PVNI in GC patients.Conclusions:1.PVI of GC is related to many clinicopathological factors,among which positive lymph node metastasis is independent risk factors for PVI of GC.2.PNI of GC is related to various clinicopathological factors,among which depth of infiltration and positive lymph node metastasis are independent risk factors for PNI of GC.3.PVNI of GC is related to a variety of clinicopathological factors,among which the depth of infiltration and positive lymph node metastasis are independent risk factors for PVNI of GC.Part 2 Prognostic factors in early gastric cancer Objects: The overall 5-year survival rate of gastric cancer patients is relatively low,and the overall prognosis is poor.AJCC/UICC guide shows the degree of tumor infiltration,lymph node metastasis,distant metastasis are the most key factors to affect the postoperative survival rate of GC.Many related studies have shown that GC radical surgery long-term survival is also associated with other clinical pathological features.it is essential to discuss the relationship between the clinical pathological features and prognosis of GC cases.Methods: 247 GC cases submitted for surgical resection from January 2014 to December 2014 were included for survival analysis.35 cases were lost to follow-up and the survival time of 7 cases were less than 2 months.A total of 205 patients were included in the survival analysis,with a median follow-up of 62.5 months(2.5 to 71.5 months).Results: Among the 205 patients with GC,the 1-year,3-year and 5-year survival rates with PVI were 74.8%,59.1% and 52%.The 1-year,3-year and 5-year survival rates with PNI were 72.4%,50.5% and 42.9%.And the 1-year,3-year and 5-year survival rates with PVNI were 68.2%,50.6% and 41.4%.The results of Kaplan-Meier analysis showed that the prognostic survival analysis was statistically significant in the 8 groups,including maximum tumor diameter,degree of infiltration,lymph node metastasis,PVI,PNI,PVNI,signet-ring cell carcinoma component and cancer nodule(P< 0.05).Multivariate analysis showed that the degree of infiltration,lymph node metastasis and PNI can seperatly be the only independent prognostic factor.Conclusions: Various clinicopathological factors influence the postoperative survival time of gastric cancer patients,among which the degree of infiltration,lymph node metastasis and nerve invasion can be used as independent indicators to evaluate the prognosis of gastric cancer patients.